A Little Help Gets You There

Sometimes in life, you may find that an extra push or helping hand was just what you needed to get you what you were seeking. This is just what happened for a patient of mine. Madam P, we shall call her, happily married for two years, had been trying to conceive for quite some time before coming in to see me.

Upon consultation, I prescribed the usual diagnostic tests to determine if there were any underlying conditions making conception difficult. These included ultrasound, a hysterosalpingogram (or HSG) as well as blood tests for Madam P, while her husband underwent semen analysis. Such tests account for a variety of aspects that may affect a woman’s ability to conceive and become pregnant, such as:

  •  Ultrasound – An essential part of infertility testing, ultrasound scans are used to examine a female patient’s reproductive organs (ovaries, uterus and fallopian tubes) for conditions preventing pregnancy.
  • HSG – A short X-ray procedure meant to locate any blockages or abnormalities of a patient’s fallopian tubes or uterus, which may hinder the passage of the egg to the uterus.
  • Blood tests – A quantitative blood test to primarily determine a patient’s level of human chorionic gonadotropin (hCG) in her blood. HCG facilitates the production of other hormones to maintain pregnancy.
  • Semen analysis – Basically, a test to determine the viability of the partner’s (male) sperm. Sperm health is evaluated in three main aspects, namely sperm number, sperm shape as well as sperm movement.

Surprisingly, and fortunately of course, all diagnostics tests for Madam P as well as her husband indicated that their reproductive health were perfectly normal. The couple had no abnormalities, so her inability to conceive remained unexplained.

In order to facilitate pregnancy, Madam P underwent intrauterine insemination (IUI), a relatively simple treatment that places the partner sperm directly inside a woman’s uterus, and thus closer to the egg.

For this procedure, the partner sperm is washed, where seminal fluid is removed and the sperm concentrated before it is placed in the uterus during either natural ovulation or ovulation induction. Here, the probability of conception increases as there is now a higher number of healthy sperm cells available as well as a shorter route to reach the fallopian tubes for fertilisation of the egg. IUI may be popularly referred to as artificial insemination, however the sperm still fertilises the egg on its own. The idea is to simply give it a little well-timed head start to increase the chances of pregnancy. Again, it should be noted that IUI acts only as an assistant to natural conception, in that sperm must still traverse the fallopian tube and fertilise the egg.
Across all patient types, the success rate for IUI based on live birth rates per cycle is around 10% to 20%, depending on factors such as fertility medication used and age. Relatively speaking, this may be perceived as having a low chance of success. However, IUI remains a simple, relatively painless and non-invasive procedure and can be the only procedure needed to achieve pregnancy. It is also more accessible, given its lower cost of treatment. Another advantage for IUI is that studies show that nearly all successful IUIs, or approximately 90% to 95% of cases, happen within 3 to 4 attempts. My patient, Madam P, successfully achieved pregnancy upon her second attempt using IUI.

You may now be asking: Dr, would this treatment suit me or my partner? Well, perhaps, if you or your partner find yourselves diagnosed for or are any experiencing any of these conditions:

  • Unexplained infertility
  • Unconducive cervical conditions for sperm movement
  • Infertility related to absent or insufficient ovulation
  • Male subfertility (abnormal sperm shape, low sperm count and weak sperm movement)
  • Semen allergy (in rare cases for women)

As mentioned earlier, Madam P’s infertility was unexplained, as her (as well as her husband’s) diagnostic tests revealed normal function across all reproductive aspects. Therefore, IUI was deemed a suitable treatment for conception, and was successful.

You are sure to have many questions. In addressing infertility, the sooner you have them answered, the better. Do list them down and call +6-03-80699333 (TMC Fertility & Women’s Specialist Centre, Puchong) or +6-03-62871000 (Thomson Hospital, Kota Damansara) or email ask@drnavdeepfertility.com to make an appointment to consult with Dr. Navdeep.